Effect of adding various doses of clonidine as an adjunct in Transversus abdominis plane block in unilateral inguinal hernioplasty

Abstract

Background: Transverses abdominis plane (TAP) block is a new regional anaesthetic technique for postoperative analgesia in abdominal surgeries, as a part of multimodal analgesia. We evaluated effect of two different doses of clonidine as an adjunct in TAP block in patients underwent unilateral inguinal hernioplasty. Methods: Sixty adult patients undergoing unilateral inguinal hernioplasty were randomized into two groups, Group A (n=30) received bilateral TAP block with bupivacaine 0.25% 38cc + clonidine (1cc) 150 microgram +1cc NS=40cc, Group B (n=30) received bupivacaine 0.25% 38cc+clonidine (2cc) 300 microgram=40cc, at the end of surgery. The postoperative pain was evaluated by visual analog score (VAS) for pain scoring at 2, 4, 6, 12 and at 24 hours. Subjective assessment of duration of analgesia was done. Results: The VAS score in patients who received clonidine 300 microgram Group B as an adjunct was significantly lower than who received 150 microgram Group A. Duration of analgesia was longer in Group B. 2 patients in Group B showed bradycardia treated with atropine. Sedation score was lesser in Group A. Conclusions: Clonidine showed dose dependant analgesia and adverse effect in TAP block for postoperative analgesia. Higher doses of clonidine may be used as an adjunct in TAP block.

Efficacy of clonidine as an adjuvant to ropivacaine in transversus abdominis plane block in adult renal transplant recipients: A double-blinded randomized controlled trial

“…used TAP block with either 150 μg or 300 μg clonidine in 60 patients undergoing unilateral inguinal hernioplasty and found that the usage of the higher dosage of clonidine resulted in significantly prolonged duration of analgesia but had more incidences of bradycardia and sedation. [ 21 ] Even with such a high dose of clonidine, the difference in pain scores among the subjects was observed only up to 6 h postoperatively. A study by Sruthi et al .…”

“…All the previous studies that reported the analgesic benefit of clonidine in TAP block were performed on patients belonging to the American Society of Anesthesiologists classes I and II. [ 21 22 23 ] In our study, the patient population was distinct and included only end-stage kidney disease patients. In the past, Adnan et al .…”

“…[ 16 17 18 19 20 ] It enhances analgesic benefits when added to TAP block in lower abdominal surgeries. [ 21 22 23 ] In the literature review, we found no study that had assessed the efficacy of clonidine as an adjuvant in TAP block for renal transplantation surgery.…”

Transversus abdominis plane block: Comparison of efficacy of varying doses of clonidine combined with levobupivacaine – A double-blind randomized trail

“…reported that increase in the dose of clonidine would increase the effect of TAP block. [17] Adverse effect of drug was also studied. In their study, Group A received bupivacaine 0.25% 38cc + clonidine 150 μg and Group B received bupivacaine 0.25% 38cc + clonidine 300 μg.…”